Abstract | BACKGROUND: OBJECT: To investigate the different clinical features between pediatric-onset and adult-onset MOG- IgG-seropositive patients in a relatively large cohort. METHODS: A total of 816 consecutive patients with suspected demyelinating disease were prospectively enrolled from three tertiary academic centers in South China from February 2016 to December 2016. Sixteen pediatric-onset cases (≤14 years old) and 34 adult-onset cases (>14 years old) seropositive for MOG- IgG were identified. Differences in clinical features between the two groups were investigated. RESULTS: There was a significant difference in the cumulative incidence of first relapse among the two groups (P = .008). Cerebral symptoms were significantly higher in pediatric-onset patients than in adult-onset patients, either at disease onset (pediatric-onset group, 10/16(62.5%); adult-onset group, 8/34(23.53%); P = .007) or throughout the course of disease (pediatric-onset group, 11/16(68.8%); adult-onset group, 10/34(29.4%); P = .009). Optic nerve symptoms were more common in adult-onset groups, but no significant difference was found between the two groups. A significantly higher rate of pediatric-onset patients (9/16, 56.3%) met the acute disseminated encephalomyelitis criteria compared with adult-onset patients (2/34, 5.9%) (P = .0003), and isolated optic neuritis was mainly diagnosed in adult-onset patients (pediatric-onset group, 2/16(12.5%); adult-onset group, 14/34(41.2%); P = .043). The MOG- IgG titer showed a significant positive correlation with total protein levels in cerebrospinal fluid, but only in adult-onset patients (r = 0.95; P = .0004). On magnetic resonance imaging, extensive white matter lesions were observed in both groups, and the number was much higher in pediatric-onset (7/15, 46.7%) than in adult-onset patients (4/29, 13.8%) (P = .043). At the last follow-up, more pediatric-onset patients (10/16, 62.5%) experienced complete recovery (EDSS 0.0 at last follow up) compared with adult-onset patients (9/34, 26.5%) (P = .014). CONCLUSIONS: Distinctive features are present between pediatric-onset and adult-onset patients with MOG- IgG. Further studies are required to determine the different underlying pathogenesis of MOG antibody at different ages.
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Authors | Lu Chen, Chen Chen, Xiaonan Zhong, Xiaobo Sun, Haixia Zhu, Xiaojing Li, Hui Yang, Yaqing Shu, Yanyu Chang, Xueqiang Hu, Zhengqi Lu, Lisheng Peng, Wei Qiu |
Journal | Journal of neuroimmunology
(J Neuroimmunol)
Vol. 321
Pg. 83-91
(08 15 2018)
ISSN: 1872-8421 [Electronic] Netherlands |
PMID | 29957392
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2018. Published by Elsevier B.V. |
Chemical References |
- Autoantibodies
- Immunoglobulin G
- MOG protein, human
- Myelin-Oligodendrocyte Glycoprotein
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Topics |
- Adolescent
- Adult
- Aged
- Autoantibodies
(blood)
- Child
- Child, Preschool
- China
(epidemiology)
- Cohort Studies
- Demyelinating Diseases
(blood, diagnostic imaging, epidemiology)
- Female
- Humans
- Immunoglobulin G
(blood)
- Male
- Middle Aged
- Myelin-Oligodendrocyte Glycoprotein
(blood)
- Prospective Studies
- Young Adult
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